Microarthroscopic study of the morphologic features of normal and pathological synovial membrane.

Abstract

The complex symptoms occurring in several internal knee diseases are usually related to changes in the synovial membrane, causing diagnostic and therapeutic problems. The conventional arthroscope, useful in establishing the diagnosis of internal derangement, is of questionable value in the differential diagnosis and evaluation of the stages of arthritis. With magnifying arthroscopy, it is possible to better show various forms of synovitis. Between 1983 and 1989, 3,000 knee joints were studied with conventional arthroscopy. In 400 of these joints, magnifying arthroscopic examination (microarthroscopy) was performed: 34 were normal, 57 had meniscal and ligamentous lesions, 220 had osteoarthritis, and 89 had inflammatory synovitis. We used two types of arthroscopes, Hamou-Storz and Microview-Wolf, adapted from a microhysteroscope, which provided a x 150 magnification of the conventional field. Referring to established microarthroscopic aspects of the synovial membrane in normal and pathological conditions, we have suggested microarthroscopic criteria for the differential diagnosis of synovitis in various pathological disorders. We believe that there are new applications for microarthroscopy because the instruments appear to have great potential value for both research and diagnosis.